Prevention of Conversion in Posterior Retroperitoneal Adrenalectomy by Measuring Preoperative Anatomical Conditions

University of Basel

Status: Completed

Conditions: Conn Adenoma; Adrenal Mass; Adrenal Tumor; Adrenal Hyperplasia; Adrenal Metastases; Pheochromocytoma

Treatments: Other: Posterior retroperitoneal adrenalectomy (PRA); Other: Lateral transperitoneal adrenalectomy (LTA)

Study type: Observational

Funder types: Other

Identifiers

NCT04071561

201901147

Details and patient eligibility

About

With our retrospective study the investigators show the limitations of the posterior retroperitoneal adrenalectomy by analyzing anatomical parameters.

The investigators compared the data from one patient who underwent a conversion with 13 patients without a conversion. Furthermore, they explored the influence of these parameters on the operation time and excluded the patient who had a conversion from this analysis.

The investigators hypothesize that by determining anatomical characteristics on cross-sectional imaging (CT or MRI), they can show the limitations of the posterior retroperitoneal adrenalectomy to prevent patients from being converted to lateral transperitoneal adrenalectomy.

Full description

Minimally invasive adrenalectomy has become the gold standard for the surgical treatment of small, benign adrenal lesions. In addition to the common laparoscopic lateral transperitoneal adrenalectomy, the posterior retroperitoneal adrenalectomy is becoming increasingly important.

To date, there is no consensus regarding the preferred approach in the resection of benign adrenal tumors. A comprehensive adrenal tumor program should be able to offer both options, however, patient selection criteria for a given approach have not yet been defined. The choice between lateral transperitoneal adrenalectomy and posterior retroperitoneal adrenalectomy is relevant for patients with unilateral tumors < 6-7 cm and without previous abdominal surgery.

The aim of this study was to determine the limits of posterior retroperitoneal adrenalectomy using anatomical parameters to enable the preferred access to be chosen preoperatively to prevent conversion. In addition, the investigators describe the relationship between these parameters and the operation time to find a measure of the degree of technical difficulty.

Enrollment: 14 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients whose adrenal gland was removed with retroperitoneal access
• Operation was between 01.07.2016 and 31.12.2018
• Operation was at the Kantonsspital Aarau

Exclusion criteria

• Patients with multivisceral resection

Trial design

14 participants in 2 patient groups

Non-conversion

Description:

In 13 patients, 14 posterior retroperitoneal adrenalectomy procedures were successfully completed and form the non-conversion group

Treatment:

Other: Posterior retroperitoneal adrenalectomy (PRA)

Conversion

Description:

Conversion to lateral transperitoneal adrenalectomy was necessary in 1 patient after starting posterior retroperitoneal adrenalectomy.

Treatment:

Other: Lateral transperitoneal adrenalectomy (LTA)

Other: Posterior retroperitoneal adrenalectomy (PRA)